WHAT IS SYSTEMIC ERYTHEMATOSUS?

In systemic (SLE) your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, SLE, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns.

Anyone can get lupus, but women are most at risk. The cause of lupus is not fully known.

It is a condition that leads to long-term (chronic) inflammation.

Alternative names • disseminated lupus erythematosus • systemic lupus erythematosus (SLE) • lupus • lupus erythematosus • discoid lupus.

Causes SLE is an auto-immune condition in which the body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain and other organs.

The underlying cause of auto-immune conditions is not fully known.

SLE is much more common in women than men. It may occur at any age, but appears most often in people between the ages of 10 and 50. African Americans and Asians are affected more often than people from other races.

SLE may also be caused by certain .

Symptoms Symptoms vary from person to person, and may come and go. Almost everyone with SLE has joint pain and swelling. Some develop . The joints of the fingers, hands, wrists and knees are often affected.

Other common symptoms include: • chest pain when taking a deep breath • fatigue • fever with no other cause • general discomfort, uneasiness or ill feeling (malaise) • hair loss • mouth sores • sensitivity to sunlight • skin rash – a butterfly rash in about half people with SLE (the rash is most often seen over the cheeks and bridge of the nose, but can be widespread and gets worse in sunlight) • swollen lymph nodes.

Other symptoms depend on which part of the body is affected: • brain and nervous system: headaches, numbness, tingling, seizures, vision problems and personality changes • digestive tract: abdominal pain, nausea and vomiting • heart: abnormal heart rhythms (arrhythmias) • : coughing up blood and difficulty breathing • skin: patchy skin colour and fingers that change colour when cold (Raynaud's phenomenon).

Some people have only skin symptoms. This is called discoid lupus.

Exams and tests To be diagnosed with lupus, you must have four out of the 11 common signs of the condition.

Your doctor will do a physical exam and listen to your chest. An abnormal sound called a heart friction rub or pleural friction rub may be heard. A nervous system exam will also be done.

Tests used to diagnose SLE may include: • antibody tests, including antinuclear antibody (ANA) panel • full blood count (FBC) • chest X-ray • kidney biopsy • urinalysis.

You may also have other tests to learn more about your condition. Some of these are: • antithyroglobulin antibody • anti-thyroid microsomal antibody • complement components (C3 and C4) • Coombs' test – direct • cryoglobulins • erythrocyte sedimentation rate (ESR) • kidney function blood tests • liver function blood tests • rheumatoid factor.

Treatment There is no for SLE. The goal of treatment is to control symptoms. Severe symptoms that involve the heart, lungs, kidneys and other organs often need treatment from specialists.

Mild forms of the condition may be treated with: • non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen for joint symptoms and pleurisy • corticosteroid creams for skin rashes • an antimalarial (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms.

Treatments for more severe lupus may include: • high-dose corticosteroids or medications to decrease the immune system response • cytotoxic drugs (drugs that block cell growth) (these medications are used if you do not get better with corticosteroids, or if your symptoms get worse when the stop taking them; side effects from these drugs can be severe, so you need to be monitored closely if you take them).

If you have lupus, it is also important to: • wear protective clothing, sunglasses and sunscreen when in the sun • get preventive heart care • stay up to date with immunisations • have tests to screen for thinning of the ().

Support groups Counselling and support groups may help with the emotional issues involved with the condition.

Prognosis The outcome for people with SLE has improved in recent years. Many people with SLE have mild symptoms. How well you do depends on how severe the condition is.

The condition tends to be more active: • the first years after diagnosis • in people under the age of 40.

Many women with SLE can get pregnant and deliver a healthy baby. A good outcome is more likely for women who receive proper treatment and do not have serious heart or kidney problems. However, the presence of SLE antibodies raises the risk of miscarriage.

Possible complications Some people with SLE have abnormal deposits in the kidney cells. This leads to a condition called lupus nephritis. Patients with this problem may go on to develop kidney failure and need dialysis or a kidney transplant.

SLE can cause damage in many different parts of the body, including: • blood clots in the legs or lungs • destruction of red blood cells (haemolytic anaemia) or anaemia of • fluid around the heart endocarditis or inflammation of the heart (myocarditis) • fluid around the lungs and damage to tissue • pregnancy complications, including miscarriage • • severely low blood platelet count • inflammation of the blood vessels.

When to contact a medical professional Call your healthcare provider if you have symptoms of SLE. Call your healthcare provider if you have this condition and your symptoms get worse or a new one occurs.

Reference MedlinePlus: NIH: US National Library of www.nlm.nih.gov/medlineplus

Additional reading http://www.health24.com/Medical/Diseases/Schizophrenia-20120721